Dry Eye Disease Patients Research Articles

Association of Killer Cell Immunoglobulin-like Receptor Genotypes and Haplotypes in Dry Eye Disease Patients Treated with Restasis and Systane

ABSTRACT Purpose: whether the Killer immunoglobulin-like receptor (KIR) genotypes and haplotypes are associated with the improvement in dry eye disease (DED) patients treated with Restasis and Systane (RS) remain unclear. Methods: Polymerase chain reaction with sequence-specific primers (PCR-SSP) was used to analyze KIR genes in a Chinese Han population of 198 severe DED patients treated with RS. Results: The higher frequencies of KIR genotype M, AF, AJ and haplotype 2 and 8 (P = .001, P = .03, P = .004, P = .000 and P = .023, respectively) and the lower frequencies of genotype AG and haplotype 1 (P = .000 and P = .000, respectively) were observed in complete responders (CR) than those in null or partial responders (NPR) of DED patients treated by RS. Conclusions: The patients with KIR genotype M, AF and AJ might be of advantage to therapy with RS, which are useful for improving novel personalized precise therapy strategy in DED patients.

Psödoeksfoliasyon Sendromunda Kuru Göz ve Meibomian Bez Disfonksiyonunun Meibografi ile Değerlendirilmesi

Objectives: To evaluate morphological changes caused by pseudoexfoliation (PEX) syndrome in meibomian glands with meibography. Material and Methods: 39 individuals with PEX syndrome and 42 individuals without PEX syndrome were included in the study. Meibomian glands, tear-film break-up time, tear volume and subjective symptoms of the study and control groups were evaluated with followings, respectively: meibography, non-invasive keratographic tear film break-up time (NIKBUT), Schirmer 1 test with anesthesia, ocular surface disease index (OSDI) questionnaire. Results: Schirmer 1 and NIKBUT values were found to be significantly lower in the participants with PEX syndrome compared to the control group (p<0.001, p=0.012; respectively). But the OSDI index and total meibograde values were found to be significantly higher in the PEX syndrome group compared to the control group (p=0.002, p<0.001; respectively). Additionally, in the PEX syndrome group, a negative correlation was determined between total meibograde value and NIKBUT value (r:-0.673; p=0.001) and a positive correlation was determined between total meibograde value and OSDI index score value (r: 0.515; p<0.001). No statistically significant correlation was determined between total meibograde value and Schirmer 1 value (p=0.847). Conclusion: PEX syndrome affects the ocular surface adversely. Causing the meibomian gland dropout by this syndrome is also among the mechanisms of this adverse effect. This condition should be considered for the diagnosis and treatment approach of dry eye disease in patients with PEX syndrome.

Коррекция состояния глазной поверхности у пациентов с синдромом «сухого глаза» на этапе подготовки к кераторефракционной операции

Aim: to analyze the prevalence of dry eye disease (DED) among adult patients with ametropias and the efficacy of its complex treatment when preparing the ocular surface for corneal refractive surgery.Patients and Methods: 1,762 patients with ametropias were examined. In addition to all of the standard eye checks, vital conjunctival and corneal staining, Scheimpflug corneal topography, and anterior segment OCT as well as patient survey were performed. Standard preservative-free tear substitutes with or without a short course of steroids, lubricants, 0.05% anionic cyclosporine emulsion (twice daily), and long-term punctal plugs were prescribed for DED.Results: mild DED was diagnosed in 1,021 patients (57.9%). Of them, corneal lesion was reported in 362 patients (35.4%) and asymptomatic DED in 250 patients (25.5%). Corneal topographic indices of one or both eyes were abnormal (as a result of DED) in 147 patients (14.4%). Significant (p≤0.05) increase in corneal epithelial thickness of one or both eyes was reported in 564 patients (55.2%). Ocular surface treatment in DED patients allowed for uncomplicated corneal refractive procedures while target refraction was achieved in 1,006 patients (98.5%). Conclusion: a complex diagnostic approach to DED involving specific tests, patient survey, corneal topography, and OCT provides the diagnosis of both manifest and latent DED. Combined treatment for conjunctival and corneal xerosis that includes tear substitutes, topical cyclosporine, and punctal plugs, improves ocular surface health in DED thus enlarging the list of indications and the safety of laser eye surgery in these patients.Keywords: dry eye disease, laser eye surgery, corneal refractive procedures, anionic cyclosporine emulsion, punctal plugs, corneal epithelium.For citation: Klokova O.A., Damashauskas R.O., Geidenrich M.S. Ocular surface treatment in dry eye patients before corneal refractive surgery. Russian Journal of Clinical Ophthalmology. 2020;20(4):180–186. DOI: 10.32364/2311-7729-2020-20-4-180-186.

Efficacy of Isotonic Seawater Solution on Inflammation of the Ocular Surface in Matrix Metalloproteinase MMP-9-Positive Dry Eye Disease Patients

Purpose: Prospective study to evaluate the anti-inflammatory efficacy of isotonic seawater solution on metalloproteinase 9 (MMP-9) levels in the tears of patients with dry eye disease (DED). Methods: A total of 50 patients were included, with the following dry eye criteria in both eyes: InflammaDry? test initially positive, ocular surface disease index (OSDI) score ≥ 12 and Results: The InflammaDry test was positive in 100% of the patients (n = 50) and in 100% (n = 100) of the eyes before treatment. In 14 (28%) patients the test became negative in both eyes, and in 15 (30%) it was negative in one of the eyes. In 43% (n = 43) of the positive eyes, MMP-9 became undetectable in the tear fluid following treatment with isotonic seawater. This change was statistically significant (p Conclusions: The washes with ophthalmic isotonic seawater solution have a significant impact on inflammation of the ocular surface in dry eye disease, with an ability to make MMP-9 levels negative in 43% of cases.

Comparison of Clinical Use of Ocular-surface Disease Index Questionnaire, Tear Film Break-up time, and Schirmer Tests in Diagnosing Dry-eye

Aims: To evaluate and compare the diagnostic values and clinical utility of the Ocular Surface Disease Index (OSDI) questionnaire, the tear film break-up time test (TBUT), and the Schirmer’s test in diagnosing dry eye disease in patients presenting with dry eye symptoms.&#x0D; Study Design: A prospective observational study.&#x0D; Place and Duration of Study: Department of Ophthalmology, AIIMS Jodhpur, Rajasthan, India. Two-month period between July 2016 and September 2016.&#x0D; Methodology: We have included 100 patients aged &gt;20 years having foreign body sensations, burning sensations, pain, dryness, blurred vision, photophobia, redness in the study. Routine ophthalmological examination was performed after OSDI questionnaire, followed by TBUT and Schirmer’s test and outcomes were evaluated.&#x0D; Results: The mean age of 100 participants was 43 ± 15.97years (range 20–78 years). The mean OSDI, TBUT, and Schirmer’s test scores were 58.67± 12.12 (range 30.0–88.9), 5.77 ± 3.49 seconds (range 0–17 seconds), and 09.78 ± 7.93 mm (range 0–32.5 mm), respectively. There was a statistically highly significant inverse correlation between the OSDI and TBUT (r = −0.597, P = &lt;0.0001), statistically significant correlation between TBUT and Schirmer test (r= -0.227, p= 0.023), whereas no significant correlation noted between the OSDI and Schirmer’s test (r= -0.142, p= 0.158). &#x0D; Conclusion: The prevalence of dry eye disease (DED) is increasing these days. For early recognition and treatment, we need rapid, reliable and less invasive diagnostic test in daily practice. The OSDI together with the TBUT is less time consuming, easy to perform and can be useful in diagnosis of DED.

Meibomian Gland dysfunction and dry eye disease symptoms in patients with type 2 Diabetes Mellitus

An important problem to date is the dysfunction of meibomian glands in patients with type 2 diabetes. The aim of our work was to analyze the prevalence of meibomian gland dysfunction and signs of dry eye disease in patients with type 2 diabetes. We examined 40 patients (80 eyes) with compensated type 2 diabetes mellitus and symptoms of dry eye disease, who made up the main group at the age of 54.00±8.00 years, and 30 patients (60 eyes) of practically healthy people, aged 51.00±8.00 years. All patients underwent visiometry, biomicroscopy, ophthalmoscopy, tonometry, compression test to evaluate the secretion of meibomian glands, Schirmer’s test for compression before and after 30 min. Afterwards, Norn test, meibography, Demodex mite test, laboratory tests (lipidogram, blood glucose, glycosylated hemoglobin). In addition, standard OSDI, McMonnies Dry Eye Questionnaire questionnaires were used and an average clipping rate of1 min was determined. Statistical processing of the obtained results was carried out using the license package “Statistica 8.0” using parametric estimation methods. Our study has shown that in patients with diabetes for more than 5 years, dry eye disease occurs more often and is dominated by moderate and severe severity. Each patient in the study group, together with the symptoms of dry eye, had signs of dysfunction of the meibomian glands of varying degrees of severity according to the compression test and objective symptoms of the disease. A significant difference was found between the clipping frequency in the control group and the main one (p≤0.01). Compared with the control group, patients with diabetes have a longer interval between the clipping movements. Meibography data show that patients in the primary group have changes in the meibomian glands in 90% of cases, while in the control group – 44%. Thus, it was found that patients with type 2 diabetes had dysfunction of meibomian glands of moderate severity in 90% of cases, which is associated with the duration of diabetes.

Pain and sensation in dry eye disease

AbstractThe recent definition of dry eye disease (DED) proposed by DEWS II includes, for the first time, neurosensory abnormalities in etiology of the disease. In DED, reduced tear secretion leads to inflammation and corneal nerve damage, which induce sensitization of corneal polymodal and mechano‐nociceptors, and an abnormal activity of cold thermoreceptors thus evoking pain and eye dryness sensations. Moreover, long‐term nerve damage and inflammation, modify the expression of ion channels involved in the stimulus detection (transduction) and excitability of ocular sensory neurons, changing their impulse firing and their connectivity at the CNS, which is the basis of neuropathic pain and dysesthesia referred to the eye surface in DED patients. These altered transducing and encoding ion channels are potential molecular targets to modulate neuropathic nerve activity in DED, currently under study. Although many subjective (surveys and questionnaires, corneal sensitivity measurement) and objective metrics (morphology and density of subbasal corneal nerves and immune cells, blink parameters, biomarkers in tears) are currently used to evaluate pain in DED patients, new instruments and procedures designed to obtain more reliable information on eye sensations and pain in DED need to be developed (SAF‐2017‐83674‐C2‐1‐R and 2‐R, Agencia Estatal de Investigación‐ERDF, Spain‐EU, and PROMETEO/2018/114, Generalitat Valenciana, Spain).

Clinical efficacy of MC2‐03 (ciclosporin eye drop) in treatment of dry eye disease patients with severe keratitis randomized in the NORTHERN LIGHTS phase 2b trial

AbstractPurposeAnti‐inflammatory treatment of moderate‐to‐severe dry eye disease (DED) remains a challenge with a need for eye drops showing better efficacy and tolerability. The effect of MC2‐03, a novel ciclosporin (CsA) eye drop using PAD™ Technology, was investigated in humans.MethodsThe NORTHERN LIGHTS trial is a 6 month phase 2b, multicenter, randomized, controlled, double‐masked trial evaluating MC2‐03 (0.03% and 0.06% CsA) administered once daily in 255 patients with moderate‐to‐severe DED with grade 3 and 4 corneal fluorescein staining (CFS) on the modified Oxford scale. The primary objective of the study was to evaluate safety and efficacy of two doses of MC2‐03 compared to vehicle and lubricant comparator. A total of 108 (42.4%) patients with severe keratitis (CFS 4) at Baseline were randomized.ResultsThe proportion of patients with severe keratitis (CFS 4) at Baseline achieving at least 2‐grade improvement in CFS at Month 6 was 63.0% for MC2‐03 0.03%, 41.4% for MC2‐03 0.06% versus 30.8% for both vehicle and lubricant comparator, showing statistical significant improvement for MC2‐03 0.03% compared to vehicle (p = 0.028) and to lubricant (p = 0.028). Further post‐hoc analysis demonstrated that the mean change in CFS from Baseline to Month 6 for MC2‐03 0.03% separated significantly from vehicle (0.8 CFS units, p = 0.012) and lubricant (0.7 CFS units, p = 0.020) with statistical significance already achieved at Month 3. Overall, the trial demonstrated favorable safety of MC2‐03.ConclusionA large unmet need exists for treating moderate‐to‐severe DED patients. The NORTHERN LIGHTS study confirms that MC2‐03 0.03% CsA is effective in treating severe keratitis in this patient group

Prospective, Multicenter, Cross-Sectional Survey on Dry Eye Disease in Japan.

Dry eye disease (DED) is commonly encountered in eye clinics and hospitals, and it is therefore very important to understand DED prevalence in outpatients. A multicenter, hospital-based cross-sectional study was conducted among outpatients in Japan to ascertain DED prevalence and relationships between DED and patient profiles, including eye disease, DED diagnosis history, and surgical history. DED was diagnosed according to diagnostic criteria of the Asia Dry Eye Society. Patient self-assessment of DED-related subjective symptoms was conducted using the 5-Item Dry Eye Questionnaire (DEQ-5). Tear break-up time was evaluated in subjective symptom-positive patients. The prevalence of DED was 55.7% in 990 patients (mean age 69.1 ± 13.4years), DED was commonly experienced in combination with other ocular diseases. In revisiting patients, 15.2% had not previously been diagnosed as DED, and their total DEQ-5 scores were higher than those of patients who had undergone DED treatment. This study revealed that more than half of the outpatients had DED. Among revisiting patients, there were many "hidden" DED patients who had not been diagnosed with DED in the past. There is a high likelihood of finding DED comorbidity in patients with other eye diseases in eye clinics and hospitals. Santen Pharmaceutical Co., Ltd. UMIN Clinical Trials Registry Identifier, UMIN000035506.

Real-World Treatment Patterns Of Cyclosporine Ophthalmic Emulsion And Lifitegrast Ophthalmic Solution Among Patients With Dry Eye.

PurposeTo assess adherence, non-persistence, discontinuation, and switching of topical cyclosporine ophthalmic emulsion 0.05% (CYC) and lifitegrast ophthalmic solution 5% (LIF) use in the real world among patients with dry eye disease (DED).DesignRetrospective insurance claims study.MethodsAdult patients with DED and ≥1 prescription claim for CYC or LIF (first claim = index date) in the IBM® MarketScan® databases from July 2016 to February 2018 were identified. Eligible patients had continuous medical and pharmacy benefits in the 12 months pre- and post-index periods, and no prior use of the index medication. The proportion of days covered (PDC), adherence, non-persistence, discontinuation, and switching were examined over the 12-month post-index period.ResultsThis study included 6537 CYC and 3235 LIF patients. The adherence rate was 5.9% for CYC and 9.7% for LIF; the median PDC was 0.3 for both cohorts. Overall, 70.8% of CYC and 64.4% of LIF patients discontinued treatment with median days to discontinuation of 89 and 29, respectively. Non-persistence was 7.1% for CYC and 6.8% for LIF (median days to discontinuation: 89 and 105). In addition, 5.0% switched from CYC to LIF, and 9.6% switched from LIF to CYC over the post-index period.ConclusionOver 60% of DED patients discontinued treatment within 12 months of initiation; the median time to discontinuation was 3 months for CYC and 1 month for LIF. Although this analysis did not capture the reasons why patients discontinued treatment, the results demonstrate there likely exists a significant unmet need amongst DED patients.

3-year Study in Dry Eye Disease Patients With Severe Keratitis Receiving Ikervis® (1mg/mL Ciclosporin)

3-year Study in Dry Eye Disease Patients With Severe Keratitis Receiving Ikervis® (1mg/mL Ciclosporin)

RECENT TRENDS IN MANAGEMENT OF KERATOCONJUNCTIVITIS SICCA (DRY EYE DISEASE)

At the air-water interface, the tear film lipid layer (TFLL), a combination of lipids and proteins plays an important role in surface tension of the tear and is necessary for the physiological hydration of the ocular surface and maintenance of ocular homeostasis. Alteration in lacrimal fluid rheology, differences in lipid constitution or down regulation of particular tear proteins are found in maximum types of ocular surface disease including dry eye disease (DED). Dry eye is a disorder of the tear film due to tear deficiency or excessive tear evaporation, which causes damage to the interpalpebral ocular surface and is associated with symptoms of discomfort. It results in changes on the ocular surface epithelia causing reduced tear quantity and surface sensitivity which leads to inflammation reactions. Managing this inflammation is very helpful in dry eye disease patients. In this article we revise the current understanding of tear film properties, ocular surface and review the effectiveness of topically applied tear supplements, thermo sensitive atelocollagen punctal plug, subtrasal ultrasonic transducers, novel liposome based gelling tear formation and insulin based ophthalmic delivery systems which help in restoring the healthy tear film.

Changes of tear film lipid layer thickness by 3% diquafosol ophthalmic solutions in patients with dry eye syndrome.

To evaluate the quantitatively changes in lipid layer thickness (LLT) when 3% diquafosol eye drop is used for dry eye patients using the tear film interferometer. A total 124 participants (32 males, 92 females; mean age, 28.9y) diagnosed with dry eye disease (DED) received topical instillation of 4 ophthalmic solutions in one eye: diquafosol, normal saline, 0.1% sodium hyaluronate and 0.3% gatifloxacin, in a masked manner. LLT was measured using an interferometer at baseline and 20min after the instillation of each ophthalmic solutions. Changes of LLT after instillation (nm, mean± standard error) were as follows: 12.6±2.0 for diquafosol (P<0.001), 1.2±2.2 for normal saline (P=0.301), 1.5±2.0 for hyaluronate (P=0.495), and 0.5±3.2 for gatifloxacin (P=0.884). Topical instillation of diquafosol increases tear film LLT in DED patients. Diquafosol 3% eye drop might be effective treatment option of evaporative DED with meibomian gland dysfunction.

A Phase IV, Multicenter, Randomized, Single-blinded (Evaluator), Active-controlled, Parallel Study for Evaluating HA 0.15% Compared With Cyclosporine 0.05%, and Efficacy of Combination Therapy in Moderate to Severe Dry Eye Disease Patients

A Phase IV, Multicenter, Randomized, Single-blinded (Evaluator), Active-controlled, Parallel Study for Evaluating HA 0.15% Compared With Cyclosporine 0.05%, and Efficacy of Combination Therapy in Moderate to Severe Dry Eye Disease Patients

Pathological consequences of anti-citrullinated protein antibodies in tear fluid and therapeutic potential of pooled human immune globulin-eye drops in dry eye disease

PurposeTo investigate the role of Anti-Citrullinated Protein autoantibodies (ACPAs) in the pathology of dry eye disease (DED) and the therapeutic potential of pooled human immune globulin-eye drops in these patients. MethodsWe investigated the presence of citrullinated proteins and ACPAs in ocular surface wash (OSW) and conjunctival impressions from patients with DED and determined the pathological consequences of OSW with high ACPA using in vitro experiments and in vivo murine models. We performed a randomized, double-masked, pilot clinical trial to determine the safety, tolerability and preliminary efficacy of using pooled human immune globulin-eye drops to treat DED patients with ACPAs in OSW. ResultsWe found that neutrophils are a source of citrullinated proteins on the ocular surface of DED patients. We detected significantly higher immunoglobulin amount and presence of several species of ACPAs in OSW from DED patients. We also found that OSW with high ACPA contributes to production of NETs, and that ACPAs cause ocular surface disease in murine eyes, both of which are reduced with addition of Immune globulins. As compared to Vehicle treatment, pooled human immune globulin-eye drops (IVIG 4 mg/mL) twice a day for 8 weeks caused significant reduction in signs and symptoms of DED with no difference in tolerability or adverse events. ConclusionsThis is the first report demonstrating ACPAs in OSW of DED patients and their contribution to ocular surface disease. The first-in-human clinical trial suggests that pooled immune globulin-eye drops are a potential new class of biologic therapies for Dry Eye patients.

Corneal epithelial thickness profile in dry-eye disease.

To characterize and evaluate the use of corneal epithelial profile maps generated by an ultrahigh-resolution optical coherence tomography (UHR-OCT) in the diagnosis and management of dry-eye disease (DED). This prospective, interventional case-control study included 115 eyes of 71 subjects (52 DED and 19 controls) imaged using an UHR-OCT. Average, maximum, and minimum, range of corneal epithelial thicknesses were extracted from epithelial profile maps. Surface regularity was quantified using the range and variance of the epithelial thickness measured along a horizontal UHR-OCT scan. The variance of thickness measurements along a scan was named epithelial irregularity factor (EIF). Symptoms of 31 DED patients (55 eyes) were quantified by questionnaire and correlated to epithelial profile findings, fluorescein staining, tear breakup time, and Schirmer's test. Twenty-one DED eyes were administered autologous serum drops and follow-up UHR-OCT images were captured. DED patients had a highly irregular corneal epithelial surface compared with controls. Epithelial thickness profile variance (EIF) and range were significantly higher in DED as compared with controls (5.79 vs. 0.77, p < 0.001 and 7.6 vs. 4.6 μm, p < 0.001). Both parameters were highly significantly correlated with questionnaire scores (EIF: r = 0.778; p < 0.001, range: r = 0.737; p < 0.001). Follow-up showed a statistically significant reduction in epithelial thickness profile variance and range of treated patients ( p < 0.001). DED patients have irregular epithelial surface that can be quantified using UHR-OCT generated CEP maps. Epithelial thickness profile range and EIF correlate accurately with patients' symptoms and could be used to follow-up patients and response to treatment.

Conjunctival HLA-DR Expression and Its Association With Symptoms and Signs in the DREAM Study.

PurposeEvaluation of dry eye disease (DED) relies on subjective symptoms and signs. We examined HLA-DR expression (HLA-DR%) in conjunctival cells, a minimally invasive biomarker with objective metrics, as an alternative method.MethodsDry Eye Assessment and Management (DREAM) study participants completed the Ocular Surface Disease Index questionnaire. Clinicians evaluated tear volume, tear breakup time, and corneal and conjunctival staining. Conjunctival impression cytology samples (n = 1049) were assessed for HLA-DR% in total cells (TCs), epithelial cells (ECs), and white blood cells (WBCs). Associations (categorized into <5%, 5%–15%, >15%–25%, and >25%) with symptoms and signs were evaluated.ResultsThe HLA-DR% varied markedly across samples. Over 40% had <5 HLA-DR% positive cells in TCs and ECs and under 23% in WBCs. Higher HLA-DR% was associated with higher conjunctival staining for ECs (mean score 2.77 for <5% and 3.28 for >25%, linear trend P = 0.009) and TCs (mean score 2.82 for <5% and 3.29 for >25%, linear trend P = 0.04) and in TCs was associated with higher corneal staining (mean score 3.59 for <5% and 4.46 for >25%, linear trend P = 0.03). HLA-DR% in WBCs did not correlated with signs (all P ≥ 0.58), and in TCs, ECs or WBCs were not associated with symptoms (P > 0.06).ConclusionsThe distribution of HLA-DR% in conjunctival cells reflects the heterogeneity of disease in DREAM participants. High percentages of samples with <5% positive cells indicate that HLA-DR% may not be a sensitive marker for DED in all patients.Translational RelevanceHigh HLA-DR% in ECs in association with high conjunctival staining may identify a subgroup of DED patients prone to epithelial disease and possibly need a different approach from current standards of treatment.

Patient-reported outcomes of autologous serum tears for the treatment of dry eye disease in a large cohort

PurposeTo assess patient satisfaction with autologous serum tears (AST) for the treatment of dry eye disease (DED). MethodsA prospective, observational case-series, including 100 participants who were treated with AST for DED. The five-item Dry Eye Questionnaire (DEQ-5), Symptom Assessment in Dry Eye (SANDE) Questionnaire, and the Treatment Satisfaction Questionnaire for Medication (TSQM) were used to assess DED symptoms and patients' treatment satisfaction. ResultsThe duration of AST treatment was 1–6 months in 25%, 6–12 months in 24%, 1–2 years in 22%, and 2–3 years in 29% of the participants. The mean cumulative DEQ-5 score was 12.7 ± 3.8 and 65% of the participants scored ≥12, which may suggest an underlying diagnosis of Sjögren's syndrome. The use of other treatments was significantly reduced after the use of AST (P < 0.001). The mean total SANDE score improved from 79.5 ± 21.8, 95% CI [75.2, 83.8] before to 42.2 ± 23.2, 95% CI [37.6, 46.8] after using AST (P < 0.001).The mean TSQM treatment efficacy, convenience, and global satisfaction scores were 73.1 ± 17.2, 95% CI [69.6, 76.5], 72.5 ± 17.5, 95% CI [69.0, 76.0], and 74.6 ± 22.7, 95% CI [70.1, 79.0]. No patients reported any side effects. ConclusionAutologous serum tears treatment in severe dry eye disease significantly reduced dry eye symptoms, with high patients’ satisfaction scores.

Association Between Single Nucleotide Polymorphisms in the Vitamin D Receptor and Incidence of Dry Eye Disease in Chinese Han Population

BackgroundDry eye disease (DED) is a chronic dysfunction of the ocular surface and has become an important public problem. Vitamin D receptor (VDR) gene polymorphism has been found to be associated with different kinds of diseases. The relationship between single nucleotide polymorphisms (SNPs) in the VDR gene should be studied.Material/MethodsIn the present case-control study, we investigated the association of VDR gene polymorphism with DED risk. Clinical data including age, gender, body mass index (BMI, kg/m2), smoking history, diabetes, and blood pressure were recorded. Serum 25-hydroxy vitamin D (25[OH]D) was chosen as the main parameter that reflected the level of vitamin D. We identified SNPs of VDR gene Apa-1, Bsm-1, Fok-1, and Taq-1 in both DED cases and healthy controls.ResultsA total of 124 DED cases and 135 healthy controls were included in this study. It was reported that aa in Apa-1 (OR=2.803, 95% CI, 1.350–5.820) and tt in Taq-1 (OR=0.362, 95% CI, 0.141–0.930) were associated with increased the risk of DED. Analysis of the allele frequencies of VDR gene polymorphisms among DED patients and healthy controls showed that allele differences in Apa-1 were significantly associated with higher risk.ConclusionsSNPs of VDR gene (Apa-1 and Taq-1) were associated with the risk of DED. No significant association of Bsm-1 and Fok-1 in VDR gene demonstrated significant effect in the incidence of DED. Thus, we found that several SNPs of VDR gene could provide significant pathogenic effects in the risk of DED.

RETRACTED ARTICLE: Comparison of 0.05% cyclosporine and 3% diquafosol solution for dry eye patients: a randomized, blinded, multicenter clinical trial

BackgroundThis study is aim to compare the clinical effectiveness between the two most prominent dry eye disease (DED)-specific eye drops, 0.05% cyclosporine (CN) and 3% diquafosol (DQ).MethodsThis is a multi-centered, randomized, masked, prospective clinical study. A total of 153 DED patients were randomly allocated to use CN twice per day or DQ six times daily. Cornea and conjunctival staining scores (NEI scale), tear break-up time (TBUT), Schirmer test scores, and ocular surface disease index (OSDI) score were measured at baseline, 4 and 12 weeks after treatment.ResultsAt 12 weeks after treatment, NEI scaled scores were significantly reduced from the baseline by − 6.60 for CN and − 6.63 for DQ group (all P < 0.0001, P = 0.9739 between groups). TBUT and Schirmer values for CN were significantly improved from the baseline at 4 and 12 weeks (P = 0.0034, P < 0.0001 for TBUT, P = 0.0418, P = 0.0031 for Schirmer test). However, for DQ, TBUT showed significant improvement at 12 weeks only (P = 0.0281). Mean OSDI score differences from the baseline to 12 weeks were improved by − 13.03 ± 19.63 for CN and − 16.11 ± 20.87 for DQ, respectively (all P < 0.0001, P = 0.854 between groups). Regarding drug compliance, the mean instillation frequency of CN was less than that of DQ (P < 0.001). There were no statistically significant intergroup differences in safety evaluation.ConclusionsThe level of improvement regarding NEI, TBUT, and OSDI scores were not significantly different between the two treatment groups. However, with regards to the early improvement of TBUT and patient compliance, patients using CN improved faster and with greater adherence to drug usage than did those treated with DQ.Trial registrationKCT0002180, retrospectively registered on 23 December 2016.